| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $326.58 | $401.66 | $8,500.00 | |
Medica
| Facility | $326.58 | $452.84 | $979.77 |
Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $326.58 | $401.66 | $8,500.00 | |
Medica
| Facility | $326.58 | $452.84 | $979.77 |